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My mother is exhibiting rapidly increasing symptoms of cognitive decline and we have been unable to find a way to get her assessed her in our area (we are in Austin, Texas). The neurologists she contacted last year all either did not accept Medicare or were not accepting new patients. She no longer seems to have the ability to follow up on this on her own, so I have been trying to help. With her permission, I've been looking for a neurology program on her behalf. I've run in to the same issue she did last year. I finally reached out to the Bigg's Institute, in San Antonio (90 minutes from us) who said they require receipt of her medical records, along with a written referral that indicates her symptoms are likely dementia-related before they will schedule an appointment, and that the appointment would be at least several months out. They said she would likely simply end up on a waiting list. I believe she needs to be assessed quickly, especially since she is rapidly losing insight into her situation.



Can anybody recommend a program anywhere in the US (we are willing to travel) that seems to have availability -- or has the "silver tsunami" already drowned availability everywhere? Any recommendations that might be helpful are tremendously appreciated. I'm not sure where to start looking, at the moment.



Thanks!

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MARCH 2023 post.
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Edit: *groovygal* - sorry to have erred on your username.
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grroovygal: As you and your mother were/are having difficulty locating a neurologist, perhaps you can get her seen at the ER (Emergency Room) since it is imperative that she be assessed by a medical professional.
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Try the Cleveland Clinic for brain health in Las Vegas.

https://my.clevelandclinic.org/locations/directions/205-cleveland-clinic-lou-ruvo-center-for-brain-health-las-vegas

Also, call the Area Agency on Aging in mom's location. They do an assessment of needs which is a place to start. They may have suggestions on your other questions as well.

And do get her checked for a UTI.

You do not need a neurologist for a dementia diagnosis. My mom never saw neurologist, Her geriatric doc did all of that, including treating of symptoms. Remember there is no cure or medication that slows the decline. All that can be done it treat symptoms.

Another option might be to check into any research opportunities that may be available in her area.

https://www.alz.org/research

https://www.nia.nih.gov/health/do-memory-problems-always-mean-alzheimers-disease
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Dr Phil has always referred people to PNP:

https://www.pnpcenter.com/
Ask for MRI or CT Scan of the Alzheimer's brain.
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My wife has ms. It takes 9 months to get an appointment. There are only 4 neurologists in the county.
welcome to Obama care
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AnitaGjen Apr 2023
The ACA has nothing to do with this issue. Why do you believe that it does?
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Have you tried the UT Health Austin's Comprehensive Memory Center? I know that it can take some time to get an appointment, but it can provide you with the necessary services.
UT Health Austin
https://uthealthaustin.org › clinics › cognitive-disorders
Comprehensive Memory Center · 1-833-UT-CARES (1-833-882-2737) · FAX: 1-512-495-5680 ·
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groovygal Apr 2023
KirstenA I did look into that first. Unfortunately, their website says they only take referrals from the UT Health clinic, and also that they are not currently taking new referrals. The UT Health clinic's website said they are not currently accepting new patients. I haven't tried calling either program directly (which is a thought). I will say that the person I spoke to at Biggs said there is definitely a shortage of Neurologists and a very high demand. Our poor healthcare providers are really overtaxed, right now. I hope it gets better soon.
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My mom had a great geriatrician. They also diagnose.He found mom to have Lewy Body…wild swings in cognition. Good Luck..
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Sorry Geaton but Specialists seem to be dropping Medicare. When Mom needed a Specialist for her thyroid I could not find one within 30 miles who would take Medicare. One practice gave me the name of a former Dr who had been in with them and opened his own practice. I called his office, he took Medicare and excepted her as a patient.

And Medicaid providers for my nephew is getting harder. The two Optometrists in the area retired. He has to go to a nearby town for dental. He does not drive so he is limited to how far he can go. Me, I will no longer drive in unfamiliar places.

I have a bill from my colonoscopy. The doctor did not charge an exorbitant fee but he got hardly anything for the procedure. Medicare needs to get up with the times.
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I'm pretty sure you meant they don't accept Medicaid, since almost every doctor & clinic accepts Medicare?

It might be "easier" to discount other causes of her cognitive decline first: check for UTI, vitamin deficiency, dehydration, thyroid issues, diabetes, over- or under-medicating of meds; stroke, HBP, etc.

If she does have dementia there is little that can be done about it anyway. And yes, there is a huge increased demand for medical care driven by our aging population PLUS we are approx. 30K doctors short due to the cost/debt of Medical schools, not to mention the US doesn't make it easy for foreign doctors to transition their licenses to the States.
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I wish I could. A gentleman wrote this a.m. on AC about his wife who has what sounds like Parkinsons, who cannot get care and is waiting for JULY to come for a neuro assessment. I in desperation suggested the ER dump as he has a wife who is tremulous, incontinent and with other symptoms who is without a diagnosis. I don't know what is happening to medical care in our country, but as an old retired RN this seems sudden to me, perhaps starting with Covid times when we were all told to go to our computers to be seen. It is quite frightening.

I am so glad your Mom has an advocate like you, and I hope against hope that others here have some useful advice for you. I wish I did. I hope you will update us.
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We used a Geriatric Behavioral Psychiatry practice that had been recommended by my LO’s Memory Care Residence.

It was one of the very best things we were able to do for her.

The process was initiated by doing a brief but very effective cognitive assessment, followed by small judicious amounts of carefully selected medications, and tips to the staff about behavioral management.

Hope you can find something helpful for her.
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